Ross Robert, Freeman Jennifer, Hudson Robert, Janssen Ian
Department of Medicine, Division of Endocrinology and Metabolism, School of Physical and Health Education, Queen's University, Kingston, Ontario, Canada K7L 3N6.
J Clin Endocrinol Metab. 2002 Nov;87(11):5044-51. doi: 10.1210/jc.2002-020570.
The independent relationships between visceral and abdominal sc adipose tissue (AT) depots, muscle composition, and insulin sensitivity were examined in 40 abdominally obese, premenopausal women. Measurements included glucose disposal by euglycemic clamp, muscle composition by computed tomography, abdominal and nonabdominal (e.g. leg) AT by magnetic resonance imaging and cardiovascular fitness. Glucose disposal rates were negatively related to visceral AT mass (r = -0.42, P < 0.01). These observations remained significant (P < 0.01) after control for nonabdominal and abdominal sc AT, muscle attenuation, and peak oxygen uptake. Total, abdominal, or leg sc AT or muscle attenuation was not significantly (P > 0.10) related to glucose disposal. Subdivision of abdominal sc AT into anterior and posterior depots did not alter the observed relationships. Further analysis matched two groups of women for abdominal sc AT but with low and high visceral AT. Women with high visceral AT had lower glucose disposal rates compared with those with low visceral AT (P < 0.05). A similar analysis performed on two groups of women matched for visceral AT but high and low abdominal sc AT revealed no statistically different values for insulin sensitivity (P > 0.10). In conclusion, visceral AT alone is a strong correlate of insulin resistance independent of nonabdominal, abdominal sc AT, muscle composition, and cardiovascular fitness. Subdivision of abdominal sc AT did not provide additional insight into the relationship between abdominal obesity and metabolic risk.
在40名腹部肥胖的绝经前女性中，研究了内脏和腹部皮下脂肪组织（AT）储存、肌肉组成与胰岛素敏感性之间的独立关系。测量指标包括通过正常血糖钳夹法测定葡萄糖处置、通过计算机断层扫描测定肌肉组成、通过磁共振成像测定腹部和非腹部（如腿部）AT以及心血管健康状况。葡萄糖处置率与内脏AT量呈负相关（r = -0.42，P < 0.01）。在对非腹部和腹部皮下AT、肌肉衰减和峰值摄氧量进行控制后，这些观察结果仍然显著（P < 0.01）。总的、腹部或腿部的皮下AT或肌肉衰减与葡萄糖处置无显著（P > 0.10）相关性。将腹部皮下AT细分为前部和后部储存并未改变观察到的关系。进一步分析将两组女性的腹部皮下AT进行匹配，但内脏AT含量有高有低。内脏AT含量高的女性与内脏AT含量低的女性相比，葡萄糖处置率较低（P < 0.05）。对两组内脏AT匹配但腹部皮下AT含量有高有低的女性进行的类似分析显示，胰岛素敏感性值无统计学差异（P > 0.10）。总之，仅内脏AT是胰岛素抵抗的强相关因素，独立于非腹部、腹部皮下AT、肌肉组成和心血管健康状况。腹部皮下AT的细分并未为腹部肥胖与代谢风险之间的关系提供更多见解。
